Kragh Jesper Vaczy
Medicinsk Museion, Institut for Folkesundhedsvidenskab, Københavns Universitet.
Dan Medicinhist Arbog. 2007;35:9-36.
In 1935 psychosurgery was invented in Portugal by Egas Moniz. A few years later the new therapy for psychiatric patients were introduced and widely used in Danish mental hospitals. Why did Danish psychiatrists utilize an uncertain and unsafe treatment, and what conditions contributed to the extensive use of psychosurgery in Denmark? To answer these questions, this article focuses on the large archives from the Directorate of the State Mental Hospitals and various mental hospitals in order to investigate the negotiations regarding psychosurgery. Especially the case notes from the State Mental Hospital in Vordingborg, a hospital with 850 beds in southern Zealand, give an insight into the doctors' considerations, when they contemplated on using psychosurgery. In the archive in Vordingborg 336 patient records from lobotomized patients have been found and subjected to statistical analysis in this article. The analysis of the patient records from Vordingborg and other state mental hospitals shows that the practise of lobotomy was a complex matter, and a number of different factors played a part in the wide use of the therapy in Denmark. Especially the dire conditions of the mental hospitals in the 1940s and 1950s made doctors consider psychosurgery a solution for the many patients living a miserable life in the back wards of the hospitals. Patients, who had spent years of their lives in the hospital's "disturbed wards", were particularly exposed to psychosurgery. In the patients records the most common indications for psychosurgery were "unruly" and "aggressive" behaviour, but other factors such as the patient's lengths of stay in the hospital, patients racked with pain, and lack of response to other somatic treatments could also prompt psychiatrists to employ lobotomy.
1935年,埃加斯·莫尼斯在葡萄牙发明了精神外科手术。几年后,这种针对精神病患者的新疗法被引入丹麦精神病院并广泛使用。为什么丹麦精神病医生会采用一种不确定且不安全的治疗方法?哪些条件促成了精神外科手术在丹麦的广泛应用?为了回答这些问题,本文聚焦于国家精神病院管理局和各精神病院的大量档案,以调查有关精神外科手术的商讨情况。特别是西兰岛南部一家拥有850张床位的福尔丁堡国家精神病院的病例记录,让我们得以深入了解医生在考虑使用精神外科手术时的考量。在福尔丁堡的档案中,发现了336份接受过脑叶切除术患者的病历,并在本文中进行了统计分析。对福尔丁堡和其他国家精神病院患者病历的分析表明,脑叶切除术的实施是一个复杂的问题,许多不同因素在该疗法在丹麦的广泛应用中发挥了作用。尤其是20世纪40年代和50年代精神病院的恶劣状况,使医生们认为精神外科手术是解决许多在医院病房后部过着悲惨生活患者的一种办法。那些在医院“精神错乱病房”度过多年的患者尤其容易接受精神外科手术。在患者病历中,精神外科手术最常见的适应症是“不守规矩”和“攻击性”行为,但其他因素,如患者在医院的住院时间、饱受疼痛折磨的患者以及对其他躯体治疗无反应等,也可能促使精神病医生采用脑叶切除术。